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L.A. Care Covered for all of L.A.

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Plan Overview

L.A. Care Has You Covered

L.A. Care Health Plan is proud to participate in Covered California™ to offer affordable health insurance to Los Angeles County residents. The 2019 Sign-Up Period for Covered California begins on October 15, 2018 and ends on January 15, 2019

No one plans to get sick or injured. But life is full of unexpected events, including ones that affect your health. Medical treatment can be very costly — a simple broken leg can cost thousands of dollars.

Having health insurance gives you peace of mind about the unexpected. L.A. Care can help you, as we offer some of the most affordable premiums in Los Angeles County for the Silver, Gold and Platinum tiers. Most residents like you are still eligible for a consumer subsidy under the Affordable Care Act, and this is what is keeping your 2019 premium costs affordable.

We are here to answer your questions and to help you find the best health coverage for your needs and the needs of your family. Call our Enrollment Support Services team at 1-855-222-4239 (TTY 711) to receive personalized support. You can also visit L.A. Care Covered™ to find the right plan for you and to learn more about L.A. Care's extensive network of physicians and hospitals. 

Shop with confidence knowing that you can get affordable health coverage through L.A. Care.

  • Our plans offer preventive care at no additional cost. This means that you may have no co-pays or co-insurance, and you do not have to meet your deductible (if there is one for your plan), before full coverage for preventive care services begins.
     
  • L.A. Care has one of the largest provider networks among Covered California plans. Members have access to this extensive network of doctors, specialists, hospitals, pharmacies and preventive care services — close to where they live, work and play.
     
  • A free Nurse Advice Line is available to all members, 24 hours a day, 7 days a week.
     
  • Health education and exercise classes and disease management programs are available at no cost through our Family Resource Centers.
     

L.A. Care Covered™ 

L.A. Care Covered™ plans offer the same essential health benefits across all metal levels (Platinum, Gold, Silver and Bronze). The amount of coverage will vary across each metal level based on the cost-sharing required. For example, under the Silver Plan 70 HMO plan, 70% of expenses are paid by the Plan and 30% are paid by the member.

We also offer a Minimum Coverage HMO plan (also known as catastrophic coverage) for applicants under the age of 30. Some people over the age of 30 may also enroll in the Minimum Coverage HMO plan if they meet certain requirements. Below is a description for each plan. The Benefits & Costs page show the amount you will pay for services under each plan.

2019 L.A. Care Covered Plans at a Glance
 

L.A. Care Covered Direct™ 

If you do not qualify for financial assistance or prefer to purchase health coverage from us, you can apply for coverage directly with L.A. Care Health Plan. We offer the same health benefits and services through our five L.A. Care Covered Direct™ plans. For help selecting the best L.A. Care Covered Direct™ plan or information about enrollment, call us at 1-855-222-4239 (TTY 711). If you are ready to apply, you may download and complete the application.

*The Silver 94, Silver 87, and Silver 73 plans are only available to members who apply for coverage through Covered California™ and are found eligible for one of these plans based on their income. See the Financial Assistance page for more details.

2019 L.A. Care Covered Direct Plans at a Glance
 

Continuity of Care

If you now see providers who are not in the L.A. Care network, in certain cases you may be able to keep seeing them for up to 12 months.  If your providers do not join the L.A. Care network by the end of 12 months, you will need to switch to providers in the L.A. Care network.  You can continue to see your providers when:

  • L.A. Care determines you have an existing relationship with your out-of-network provider. An existing relationship means you saw the out-of-network PCP or specialist at least once during the 12 months prior to the date of your initial enrollment with L.A. Care for a non-emergency visit.
     
  • Your out-of-network provider is willing to accept the higher of L.A. Care’s contract rates or Medi-Cal FFS rates.
     
  • Your out-of-network provider meets L.A. Care’s applicable professional standards and has no disqualifying quality-of-care issues.
     
  • Your out-of-network provider is a California State Plan approved provider; and
     
  • The provider supplies L.A. Care with relevant treatment information.

Members, their authorized representatives, or providers may make a direct continuity of care request to L.A. Care in writing or by telephone.

At any time, a member may change providers to a provider who is a member of an L.A. Care network.